Interstitial Cystitis
Interstitial cystitis, also called bladder pain syndrome, is persistent bladder-region pain or pressure associated with urinary frequency or urgency.
Key takeaways
- Pain often worsens as the bladder fills and eases after urination, unlike urgency without pain in overactive bladder.
- Repeated negative cultures and exclusion of stones, cancer, infection and pelvic disease are important before diagnosis.
- No single treatment works for everyone; care progresses from education and trigger management to medicines or procedures.
The listings below do not establish bladder pain syndrome; urine testing and urological or pelvic assessment should guide treatment.
Establishing the pattern
A bladder diary records pain, frequency and volumes. Urinalysis and culture exclude infection, while persistent blood in urine requires evaluation. Pelvic-floor tenderness, endometriosis, vulvodynia and bowel pain may coexist. Cystoscopy is used selectively, especially to identify Hunner lesions.
Layered treatment
Education, timed voiding, pelvic-floor physiotherapy and avoiding person-specific dietary triggers are initial options. Oral or bladder-instilled medicines have variable evidence and adverse effects. Procedures target selected refractory disease; repeated antibiotics are not useful without infection.
When to seek urgent care
Seek urgent care for fever with flank pain, inability to urinate, visible blood with clots, severe sudden pelvic pain, repeated vomiting or pain and bleeding when pregnancy is possible.